Anesthetics Mind Map

Anesthetics - Mind Map

3 years ago by: Adrienne Ramey
  • Anesthetics
    • Anesthesia is defined as the reversible state of unconsciousness.
      • Ideal Anethesia
        • Rapid onset (LOC & sensation), skeletal muscle relaxation, inhibition of sensory & autonomic reflexes, amnesia, rapid, uneventful recovery after drug has been stopped, and minimum toxic adverse effects.
      • Types of Anesthesia
        • General
          • Stages of General Anesthesia:
            • Stage 1: Analgesia, this is where you lose the ability to feel pain.
            • Stage 2: Excitement (Delirium), this where you would become deeply confused and possibly violent.
            • Stage 3: Surgical Anesthesia, this is typically where the surgeon wants the patient to be and remain until the procedure is finished.
            • Stage 4: Medullary Paralysis, at this stage the breathing ability is cut out and a ventilator is needed.
            • Anesthesiologist try to rapidly take the patient from stage 1 to stage 3 and skip stage 2. This is called induction of anesthesia.
          • General Anesthetic Agents: Classified based on routes of administration
            • Inhalation & IV
              • Inhalation: better controlled but longer time to action
                • Inhaled Agents: Halogenated Liquids: -fllurane group; en-flurane, Halothane, Iso-flurane, Des-flurane, and Sevoflurane.
                  • Des-flurane and Sevoflurane are the most commonly used.
                • Inhaled Agents: Gas: Only one in clinical use; Nitrous Oxide
              • IV: rapid onset but less precise control. The ideal application would be to combine the two.
                • IV Anesthetics: Barbiturates benzodiazepines, opiod analgesics, ketamine (dissociative anesthesia), and propofol (Diprivan)
            • Adjuvants in general anesthesia is used to supplement the effect if the general anesthetic drugs for optimal patient comfort. This is managed by pre-operative medications and neuromuscular blockers.
              • Adjuvants: Pre-operative meds; Sedatives such as barbituiates, opiods, or benzodiazepines reduce anxiety. Antihistamines such as promethazine helps with sedation and nausea. Stomach acid controllers such as Tagamet and Zantac may be distributed to keep the patient from developing a stomach ulcers.
              • Adjuvants: Neuromuscular Blockers; skeletal muscle paralytics, this will release the tone from your muscles.
            • General Anesthetics: Concern for PTs: Recovery from anesthetic, bronchial secretions and clearance issue, long-term effects on cognition, and the age related impacts.
        • Local
          • Local Anesthetics: agents cause loss of sensation in a specific body part or region. Used based on operative site, nature of procedure, type of regional anesthesia desired, patient's size, general health, and duration of action.
            • Routes: topical, transdermal, and infiltration. LAST-Local Anesthetic Systemic Toxicity: S&S are tinnitus, agitation, restlessness, decreased sensation on the tongue/around mouth, bradycardia, cardiac depression, etc...
    • Skeletal Muscle Relaxants
      • Typical use- suppress hyper-excitable muscle action. Potent analgesics. Agents: anti-spasms, anti- spasticity, Dual (anti-spasms & anti-spasticity), and botulinum (Botox)
        • Anti-Spasm- Diazepam (Valium)- primarily a benzodiazepine. This is a supraspinal sedative.
          • Anti-Spasmodics is used for rest and short-term relief of muscle spasms associated with acute painful MSK injuries. These are often combined with NSAIDs.
        • Anti-Spasticity Drugs: Baclofen, Dantrolene Sodium, and Botulinum
          • Baclofen is an inhibitor on the alpha motor neuron in the spinal cord. It can be administered orally, systemically, and intra-thecally. It is used to reduce spasticity in traumatic spinal cord injuries and Multiple Sclerosis.
          • Dantrolene Sodium is the only musculoskeletal drug that directly inhibits calcium release at the skeletal muscle level. This drug is used for severe cases of spasticity regardless of pathology.
          • Botulinum controls local muscle hyperexcitability. Botulinum is actually a toxin purified from Botulism. Of 7 known serotypes there are only 3 approved for clinical use. Botox, Dysport, and Myobloc. These drugs are used for dystonia, spasmodic Torticollis, and cosmesis. Although these drugs are often used they are temporary fixes with relief lasting about 3 months.
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